Provider Demographics
NPI:1649363094
Name:BREWER, ALAN R (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:BREWER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:611 WEST FRANCIS STREET
Mailing Address - Street 2:SUITE 290
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-0614
Mailing Address - Country:US
Mailing Address - Phone:308-696-8230
Mailing Address - Fax:308-534-4247
Practice Address - Street 1:611 WEST FRANCIS STREET
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-0614
Practice Address - Country:US
Practice Address - Phone:308-696-8230
Practice Address - Fax:308-534-4247
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2014-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO40035207LP2900X
NE18706207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026132900Medicaid
CO75553066Medicaid
NENA1095125Medicare PIN
COCF72985Medicare PIN
NE10026132900Medicaid